Minimum Monthly Maintenance Needs Allowance (MMMNA)

When one spouse is approved for Long-Term Care Medicaid, most of that spouse’s income goes toward the cost of care. To keep the spouse at home (the “community spouse”) from being left without enough to live on, federal law guarantees them a minimum monthly income. That guaranteed amount is the Minimum Monthly Maintenance Needs Allowance (MMMNA). This guide explains how it works in 2026.

Figures change periodically. Double-check current amounts before relying on them.

2026 federal MMMNA figures

Source: CMS, 2026 SSI and Spousal Impoverishment Standards (Medicaid.gov). The minimum is tied to the federal poverty level and changes each July 1. The maximum changes each January 1, based on inflation.

How the MMMNA works

The MMMNA is not a payment from Medicaid. It is a way of redirecting part of the applicant’s income to the spouse at home.

1. The state figures the spouse at home’s MMMNA (at least the minimum, and possibly more if housing costs are high).
2. The state looks at the spouse at home’s own income.
3. If the spouse at home’s income is below the MMMNA, part of the applicant’s income can be paid to the spouse at home to make up the difference. That amount is called the community spouse monthly income allowance.
4. If the spouse at home’s income is already above the MMMNA, no income is redirected.

The spouse at home’s own income is never taken for the applicant’s care.

The housing (excess shelter) adjustment

The MMMNA can be higher than the minimum if the spouse at home has high housing costs. Here is how:

1. Add up the spouse at home’s monthly shelter costs: rent or mortgage payment (principal and interest), property taxes, homeowners insurance, condo or co-op fees, and a utility allowance set by the state.
2. Subtract the housing standard ($811.50 a month from July 1, 2026).
3. If there is anything left, that is the excess shelter allowance. Add it to the minimum MMMNA.
4. The total cannot be more than the maximum, $4,066.50, unless a fair hearing or court order allows more.

Some states skip this math and simply give every spouse at home the maximum. Each state guide shows the state’s approach.

Worked example

Ruth’s husband Sam is approved for nursing home Medicaid in August 2026. Ruth lives at home.

• Ruth’s own income: $1,200 a month (Social Security).
• Ruth’s shelter costs: mortgage $600, property tax and insurance $250, plus a state utility allowance of $400 (a made-up figure for this example) = $1,250.

Step 1: excess shelter. $1,250 − $811.50 = $438.50.

Step 2: Ruth’s MMMNA. $2,705 + $438.50 = $3,143.50. This is below the $4,066.50 maximum, so it stands.

Step 3: the shortfall. $3,143.50 − $1,200 = $1,943.50.

Up to $1,943.50 a month of Sam’s income can be paid to Ruth. If Sam’s income is $2,500, he keeps his personal needs allowance, $1,943.50 goes to Ruth, and the rest goes to the nursing home.

If Sam’s income were less than that, Ruth would get what is available after his personal needs allowance. Medicaid does not make up the difference.

Allowances for other family members

If a dependent child, parent or sibling lives with the spouse at home, the applicant’s income can also be used for a family allowance. Under federal law, it is generally one-third of the amount by which the minimum MMMNA exceeds that family member’s own income. With the $2,705 minimum, the most this can be per family member is about $901.67 a month.

The order of deductions

After approval, the applicant’s income is applied in this order (the “post-eligibility” calculation):

1. Personal needs allowance for the applicant (each state sets it; for example, $160 a month in Florida and $60 a month in Pennsylvania).
2. Community spouse monthly income allowance (the MMMNA shortfall).
3. Family allowance, if any.
4. Health insurance premiums and certain medical costs not covered by Medicaid.
5. The rest goes to the nursing home (or toward the cost of waiver services).

Raising the MMMNA

The MMMNA can be raised above the standard amount if:

• a fair hearing finds “exceptional circumstances resulting in significant financial duress,” such as large medical bills for the spouse at home; or
• a court orders spousal support.

See Raising the allowances through a fair hearing. A Certified Medicaid Planner (CMP) can help prepare the income and housing figures and any hearing request.

MMMNA and home care waivers

When one spouse gets care through a home and community-based services waiver, the spousal impoverishment rules generally apply as they do for nursing home care. Some waiver programs use their own income allowances. See your state guide.

Common questions

Does the spouse at home have to apply for the MMMNA? It is part of the application and post-eligibility calculation. The spouse at home usually has to provide proof of income and housing costs.

Is the MMMNA taxable? The money is the applicant’s income redirected to the spouse at home. Tax treatment depends on the type of income. A tax preparer can explain.

What if the spouse at home’s income goes up? The allowance is recalculated, often at renewal or when the change is reported.

Does the MMMNA apply if both spouses are in care? Not in the usual way. See When both spouses need care.

Two more examples

When the spouse at home already has enough income. Gail’s own income is $3,500 a month. Her shelter costs are low, so her MMMNA is the minimum, $2,705. Because her income is already above that, none of her husband’s income is redirected to her. All of his income, after his personal needs allowance and insurance premiums, goes to the nursing home. Gail keeps all of her own $3,500.

When housing costs push the allowance to the cap. Ed rents an apartment for $2,100 a month, and his state’s utility allowance adds $450 (a made-up figure for this example). His shelter costs are $2,550. Excess shelter: $2,550 − $811.50 = $1,738.50. His MMMNA would be $2,705 + $1,738.50 = $4,443.50, but the maximum is $4,066.50, so his MMMNA is $4,066.50. If Ed’s own income is $1,500, up to $2,566.50 of his wife’s income can be paid to him.

What counts as income for the spouse at home

For the MMMNA, the state looks at the spouse at home’s gross monthly income, such as:

• Social Security;
• pensions and annuities;
• wages, if still working;
• interest, dividends and rental income.

The spouse at home will usually need to send proof, such as an award letter or pay stubs.

Making sure the allowance is actually paid

The allowance only counts if the applicant’s income is actually paid to the spouse at home. The usual way is a monthly transfer from the applicant’s account to the spouse at home’s account, or a change in where a pension is deposited. If the money is not transferred, the state may count it toward the nursing home bill.

A quick checklist for the spouse at home

When one spouse applies, the spouse at home should be ready to show:

• proof of their own income for the current year;
• their mortgage or rent statement;
• their property tax bill and homeowners insurance bill;
• condo or co-op fee statements, if any;
• proof of who else lives in the home, if asking for a family allowance;
• records of any large medical bills, if asking for a higher allowance at a hearing.

The state uses these to set the MMMNA. Updated figures may be needed at each renewal, and whenever the federal minimum changes on July 1.

Why the minimum changes in the middle of the year

The minimum MMMNA is set at 150 percent of the federal poverty level for a household of two, and the law makes the new figure take effect each July 1. The maximum, by contrast, rises each January with inflation. That is why a spouse at home approved in the first half of 2026 started with a minimum of $2,643.75, and the minimum rose to $2,705 on July 1, 2026. States usually update allowances automatically, but it is worth checking the next notice after July to see that the new amount was applied.

Related guides

• Spousal impoverishment rules
• Community Spouse Resource Allowance (CSRA)
• When both spouses need care
• How to apply for Long-Term Care Medicaid
• State guides

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.